Malignant Melanoma of the Anorectum: Report of Four Cases

Abstract

Four cases of anorectal malignant melanoma are reported in this paper. All patients underwent an abdominoperineal resection with lymph node dissection for a curative operation and received postoperative chemotherapy with dacarbazine, ranimustine, and vincristine, either with or without interferon-beta. One of these patients has been observed for more than 6 years postoperatively without any evidence of recurrence. The other three patients had advanced diseases at the time of diagnosis, and died within 3 years after operation. The prognosis of anorectal malignant melanoma is considered to be directly related to tumor size and depth. Therefore, a staging system and treatments based on the tumor size and depth (or thickness) are needed.

Primary anorectal melanoma: A case report with extended follow-up

“…On the other hand, the main arguments against APR are its associated morbidity and mortality, and a high incidence of inguinal lymph node metastasis (not resected with this approach). Additionally, there is no evidence of a survival benefit of APR compared with WLE, based on disease-free survival curves [3,14,15]. As a result, it is recommended that local therapy for the primary tumor should be a sphincter-sparing local excision with normal margins when technically feasible [14,15].…”

“…Additionally, there is no evidence of a survival benefit of APR compared with WLE, based on disease-free survival curves [3,14,15]. As a result, it is recommended that local therapy for the primary tumor should be a sphincter-sparing local excision with normal margins when technically feasible [14,15]. Hence, APR should be reserved for lesions that cannot be removed by local excision (local bulky disease), or for salvage surgery in selected cases of isolated local recurrence [14,15].…”

“…As a result, it is recommended that local therapy for the primary tumor should be a sphincter-sparing local excision with normal margins when technically feasible [14,15]. Hence, APR should be reserved for lesions that cannot be removed by local excision (local bulky disease), or for salvage surgery in selected cases of isolated local recurrence [14,15]. Also, prophylactic bilateral inguinal lymphadenectomy in patients without clinically evident lymph nodes is not recommended due to the significant complications [14].…”

“…Also, prophylactic bilateral inguinal lymphadenectomy in patients without clinically evident lymph nodes is not recommended due to the significant complications [14]. Concerning metastatic ARM, operations are most likely to be palliative surgery, and APR is widely performed, but it can be avoided when WLE is technically feasible [15]. In severely ill patients unable to tolerate any surgical procedures, intramural injections of natural interferon beta and systemic administration of dacarbazine has been used with good results [16].…”

The clinical features and optimal treatment of anorectal malignant melanoma

“…If the lesion is thick (>3 mm) and large (>30 mm), curative surgery cannot be achieved [29]. In this case, conservative local excision and adjuvant therapy can result in a better prognosis [6].…”